{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T17:04:53Z","timestamp":1761239093044,"version":"build-2065373602"},"reference-count":86,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:00:00Z","timestamp":1686700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, Portugal"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people\u2019s quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. Methods: A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. Results: A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 \u201cFloating so that staffing is equalised among units\u201d is strongly associated with a shorter PU healing time. Conclusion: A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times.<\/jats:p>","DOI":"10.3390\/healthcare11121751","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T01:32:57Z","timestamp":1686792777000},"page":"1751","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal\u2019s Long-Term Care Units"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1130-3678","authenticated-orcid":false,"given":"Katia","family":"Furtado","sequence":"first","affiliation":[{"name":"Out Patient Department, Hospital of Portalegre, Unidade Local de Sa\u00fade do Norte Alentejano, 7300-312 Portalegre, Portugal"},{"name":"Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, Av. Prof. Egas Moniz, 1600-096 Lisbon, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade de \u00c9vora, 7000-671 \u00c9vora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9002-1865","authenticated-orcid":false,"given":"Jaco","family":"Voorham","sequence":"additional","affiliation":[{"name":"DTIRS\u2014Data to Insights Research Solutions, 1750-307 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1644-9502","authenticated-orcid":false,"given":"Paulo","family":"Infante","sequence":"additional","affiliation":[{"name":"Research Center in Mathematics and Applications (CIMA), Instituto de Investiga\u00e7\u00e3o e Forma\u00e7\u00e3o Avan\u00e7ada (IIFA), Universidade de \u00c9vora, 7000-671 \u00c9vora, Portugal"},{"name":"Departamento de Matem\u00e1tica, Escola de Ci\u00eancias e Tecnologia (ECT), Universidade de \u00c9vora, 7000-671 \u00c9vora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5517-4855","authenticated-orcid":false,"given":"Anabela","family":"Afonso","sequence":"additional","affiliation":[{"name":"Research Center in Mathematics and Applications (CIMA), Instituto de Investiga\u00e7\u00e3o e Forma\u00e7\u00e3o Avan\u00e7ada (IIFA), Universidade de \u00c9vora, 7000-671 \u00c9vora, Portugal"},{"name":"Departamento de Matem\u00e1tica, Escola de Ci\u00eancias e Tecnologia (ECT), Universidade de \u00c9vora, 7000-671 \u00c9vora, Portugal"}]},{"given":"Clara","family":"Morais","sequence":"additional","affiliation":[{"name":"Administra\u00e7\u00e3o Regional de Sa\u00fade do Alentejo, Largo do Jardim do Para\u00edso, n\u00ba 1, 7000-864 \u00c9vora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-7306","authenticated-orcid":false,"given":"Pedro","family":"Lucas","sequence":"additional","affiliation":[{"name":"Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, Av. Prof. Egas Moniz, 1600-096 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7554-8041","authenticated-orcid":false,"given":"Manuel","family":"Lopes","sequence":"additional","affiliation":[{"name":"Comprehensive Health Research Centre (CHRC), Universidade de \u00c9vora, 7000-671 \u00c9vora, Portugal"},{"name":"S\u00e3o Jo\u00e3o de Deus School of Nursing, Universidade de \u00c9vora, 7000-671 \u00c9vora, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"ref_1","unstructured":"Haesler, E. (2019). EPUAP\/NPIAP\/PPPIA. Available online: https:\/\/www.internationalguideline.com\/static\/pdfs\/Quick_Reference_Guide-10Mar2019.pdf."},{"key":"ref_2","first-page":"2420","article-title":"Preventive interventions for pressure ulcers in long-term older people care facilities: A systematic review","volume":"28","author":"Stolt","year":"2018","journal-title":"J. Clin. 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